mgmaniac45

In regards to paperwork, it is a curse we will never be rid of, neither in the hospital or in home health. At our agency, we as staff RN's got together and "requested" that the Supervisor ride with us on a typical day with at least 1 admit + 6-7 visits. They were also "requested" to do the paperwork. Imagine what happened! Those supervisors who hadn't done patient care or field work for a while very quickly found out how much work is needed to climb the peperwork mountain. It is easy to say the p/w burden is easy when the supervisor sees only the individual forms one at a time. The realityof doing it all, plus getting, like others, only $40 for it was a wake-up for many of the supervisors. I now am a supervisor myself in a small agency. We adopted a paperwork reduction plan that consolodated as many forms as possible, and made as many forms into checkoffs as possible. Our recent State surveys were both outstanding, so it can work. My Nurses aren't as overwhelmed either. Doing p/w in the driveway of a client's home is not new, but not allowing time at the office is a MISTAKE!

I am the Nursing Supervisor for a Home Care Agency. I did home care as a Staff RN for 10 years. The biggest problem I see in going into Home Care is knowing your limitations, and your Supervisor knowing your limitations. ASK the scheduler or Supervisor if the patient has any high-tech needs BEFORE you accept the assignment, and don't go out and try to "wing it". Home Care forces you to become very proficient in assessment of patients, and to do it right, the Nurse must be aggressive in being a patient advocate as well as advocating for yourself and for your needs. Too often I have followed Nurses on a case who were not fully competent in caring for that patient. Usually it is due to poor orientation. In an effort to "fill a slot" Nurses are assigned just because there is an RN after their name. Everyone is on a different learning curve. At our Agency, I go out with the Nurse to the first shift that they are scheduled to work for each new patient. I stay to orient them to the patient and to be there for questions and support. It usually takes only 1-2 hours to make the Nurse comfortable. I also do an extensive orientation prior to hire, at least a week, with hands-on return demos (on teaching dolls) by the applicant for trache care, gt care, IV insertion, etc. I have also identified some Staff RN's with excellent skills to accompany the new employees to their first visits. It helps to overcome that feeling of being alone out there. Start out by doing routine cases, and not a full assignment. Riding with another Nurse sounds good, but I think you have to be an official employee of the agency due to confidentiality. I worked for 10 years in the Hospital, but Home Care is my "Home" and I have never looked back. Give it a shot!!!